Many patients rely on pain medications to manage migraines but did you know those medications may actually be causing you more headaches? A recent studyfound that medication overuse causes daily headaches in 1 in 50 people. Fortunately, there are natural treatment options that don't put you at risk for worsening head pain.
Cases studies have suggested that chiropractic is beneficial for migraine treatment in pregnant women and children but a 2000 study was one of the the first randomized, controlled trials assessing the efficacy of chiropractic for migraine.
The study involved 127 participants between the ages of 10 and 70. All had been diagnosed with migraines, and had a minimum of at least one migraine per month. Half of the patients received chiropractic treatments, while the other half served as a control group. Treatment consisted of two months of chiropractic spinal manipulations, with a maximum of 16 treatments. Over the course of the study, participants completed headache diaries noting the frequency, intensity, duration, disability, associated symptoms, and medication use for each migraine.
The treatment group showed statistically significant improvements in average responses for migraine frequency, duration, disability, and medication use when compared to the control group. Twenty-two percent of participants reported more than a 90% reduction of migraines after the 2 months of treatment. The results of this study support previous information that some people report significant improvement in their migraines after chiropractic spinal manipulation.
Given that a high percentage of people with migraines report stress as a major migraine factor, it appears likely that chiropractic care affects physical conditions related to stress, thereby reducing the effects of the migraine.
A more recent study published in 2012 demonstrated that chiropractic care reduced pain severity in migraine patients by an average of 68%. In other words, chiropractic patients had their pain levels drop from an average of 5 to 0.5 on scale of 1 to 10.
Jahangiri JN, Vatankhah N, and Baradaran HR. Reduction of Current Migraine Headache Pain Following Neck Massage and Spinal Manipulation. Journal of Therapeutic Massage and Bodywork. 2012; 5(1): 513.
Tuchin P, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics 2000; 23 (2)
Medical doctors are increasingly ignoring the recommended guidelines for treating back pain, a new study from the Journal of American Medical Association finds.
Researchers from the Beth Israel Deaconess Medical Center in Boston examined records for 23,918 doctor visits related to back pain between 1999 and 2000. They discovered that medical doctors are actually getting worse at employing evidence-based treatments.
Current guidelines from the American Medical Association recommend that acute back pain be treated first with conservative, active treatments like chiropractic care and exercise rehabilitation. Over-the-counter non-steroidal anti-inflammatory drugs can be used to ease short-term pain, rather than narcotics like Oxycontin which can actually make matters worse, according to recent research.
However researchers found that physicians are overprescribing narcotics and overusing expensive testing.
During the study period, prescriptions for narcotics grew from 19.3% to 29.1%, reflecting a national trend of growing opioid use. Lead researcher, Dr. John Mafi, explained that during the 1990s medical doctors were widely accused of ignoring patients' pain. While some of the criticism was valid, many physicians overreacted by doling out more serious painkillers. Now around 43% of patients with back pain show signs of substance abuse disorders, Mafi and his colleagues found.
Doctors are also relying too heavily on imaging techniques no longer deemed necessary for every type of spinal pain. Use of MRI and CT scans grew from 7.2% to 11.3% during the study period, despite research demonstrating such scans are not always useful for many cases of back and neck pain. Although these scans do not harm the patient, they typically don't find anything wrong, and can cost around $1,000 per a scan.
That may be why patients under standard medical care tend have more medical costs associated with their back pain treatment compared to chiropractic patients, according to a recent study. Chiropractic patients can also expect to receive evidence-based treatments like exercise therapy and spinal adjustments. A study of military personnel with back pain earlier this year found that those treated by a chiropractor had better results compared to patients treated with standard medical care alone.
Mafi JN, et al. Worsening trends in the management and treatment of back pain. JAMA 2013; doi:10.1001/jamainternmed.2013.8992.
Chiropractic adjustments were just as effective as epidural injections for patients with back pain in a new study -- without the risks and at lower cost.
The findings show that chiropractic can significantly reduce pain in patients with lumbar disc herniation, and is less expensive than medical treatment.
Lumbar epidural injections are frequently used for back pain and sciatica in patients with lumbar disc herniation, failed back surgery syndrome, and spinal stenosis. During the procedure, a physician injects a high dose of pain medication, and sometimes steroids, into the area of the lumbar spine around the damaged nerve. This temporarily reduces inflammation and pain.
Although the injections are widely used, controversy lingers due to the lack of a studies with placebo controls, and questions about the effects of steroids versus anesthetic alone. Side effects of steroids include a weakening of muscles and spinal bones around the affected nerve and a disruption of the body's natural hormone balance. It's also unclear whether epidural injections are more effective than other conservative treatments for lumbar disc herniation.
While a number of studies have established the efficacy of chiropractic for low-back pain, fewer have tested its comparative effectiveness with other treatments for lumbar disc herniation.
In a new study from the Journal of Manual and Physiological Therapeutics, researchers from Switzerland compared the effects of chiropractic spinal manipulative therapy (SMT) and epidural nerve root injections (NRI). The study included 102 with symptomatic, MRI-confirmed lumbar disc herniation who were treated with either SMT or NRI.
After one month of treatment, both groups experienced significant improvements. Of the patients under chiropractic care, 76.5% said they were "much better" or "better" compared to 62.7% of NRI patients. Sixty percent of chiropractic patients had a significant reduction in pain compared to 53% of NRI patients. These slight differences were not statistically significant.
While none of the chiropractic patients received surgery, three of the NRI patients eventually opted for an operation.
Since the treatments were considered equally effective, the cost analysis became even more important for comparing both treatments, the researchers pointed out. On average, one month of chiropractic adjustments was less expensive than NRI ($558 vs. $729). Their analysis included only the "minimum cost" of NRIs, and did not take into account other costs that are frequently tacked on like additional consultations with clinicians, multiple injections, or possible surgery. Additionally, treatment cost for chiropractic patients may have been slightly higher than normal since they were required to receive an MRI to be in the study. Many chiropractic patients do not receive MRI because imaging guidelines do not recommend MRIs for patients with lumbar disc herniation in most cases. In contrast, MRIs are typically performed before injections or other more invasive procedures.
Although randomized trials are needed to confirm these results, the authors concluded that, "There were no significant differences in outcomes between the more universally accepted treatment procedure of NRI compared to SMT."
This study suggest that patients can experience substantial relief from chiropractic care without worrying about the side effects of steroids or drugs. It may even save them money, since research suggests that chiropractic patients have lower annual medical costs compared to patients under traditional care.
Peterson, CK, et al. Symptomatic Magnetic Resonance Imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections. Journal of Manipulative and Physiological Therapeutics 2013; doi: 10.1016/j.jmpt.2013.04.005.
If you spend your days in an office, you're probably familiar with the aches and pain that come with long hours of computer work. A new study showed that up to 89% of office workers suffer from some sort of musculoskeletal pain; whether that be in the neck, back, shoulders, wrists, or knees.
Although this pain can start as a dull ache at work, if left unaddressed, it may develop into a repetitive motion injury or other serious disorder. Seeking early treatment can reduce your risk for developing these conditions. Studies suggest that chiropractic care can relieve and prevent carpal tunnel syndrome, back pain, and neck disorders associated with working.
Work-related Pain Study
To estimate the prevalence of musculoskeletal (MSK) conditions in office workers, researchers surveyed 91 employees who worked at a university office setting. The employees rated their pain and responded to questionnaires on job satisfaction and health.
Neck pain was the most common complaint, affecting 69.2% of workers. Lower back pain was the second most common (58.2%), followed by knee problems (41.8%), shoulder concerns (35.2%) and pain in the upper back (34%). People with MSK complaints were also more likely to be dissatisfied with their jobs. Wrist, shoulder, and low-back pain were most the significant predictors of poor job satisfaction.
Other recent research has shown that stressed, over-worked employees have an increased likelihood of suffering from back pain, headache, and shoulder problems.Stress of course isn't the only thing causing musculoskeletal pain. Poor posture, unhealthy work stations, and previous musculoskeletal injuries can exacerbate the risks associated with repetitive motions or long hours hunching over a computer.
Doctors of chiropractic can create treatment plans that address the multifaceted nature of work-related pain. Not only do chiropractors work to correct dysfunctions in the joints and spine, they'll also help you identify appropriate preventive measures through posture correction, ergonomic training, and exercise therapy. Some studies suggests that chiropractic adjustments may also improve your body's response to inflammation and stress, providing you with protective benefits against further MSK injuries.
Loghmani A, et al. Musculoskeletal symptoms and job satisfaction among office-workers: A Cross- sectional study from Iran. Acta Medica Academica 2013;42(1):46-54. doi: 10.5644/ama2006-124.70.
An estimated 60-80% of people will suffer from low-back pain at least once in their lifetime. However, the treatment of chronic lower back pain is complex, and the outcome remains unpredictable. Doctors are advised to recommend that patients follow a program of active exercise to alleviate their symptoms. However, patients may be reluctant to do so because of their pain.
A recent study compared the effects of chiropractic treatment followed by exercise versus a placebo or 'sham' treatment followed by the same exercise. The researchers hypothesize that chiropractic adjustments which are believed to induce an immediate analgesic effect may enhance the benefits of exercise for patients with lower back pain.
The study involved patients with chronic, non-specific lower back pain. The first group received spinal adjustments plus active exercise therapy. The second group received a detuned ultrasound 'sham' treatment followed by active exercise. Both groups underwent eight treatment sessions over 4 to 8 weeks.
The analgesic effect of spinal adjustments were measured by evaluating pain intensity both before and immediately after each therapeutic session. Periodically, researchers also evaluated participants' disability, fear-avoidance beliefs, and erector spinae and abdominal muscle endurance (measured with Sorensen and Shirado tests).
The participants who received spinal adjustments experienced a better immediate analgesic effect, along with lower disability and a trend toward lower pain levels. The researchers concluded that manual therapy, immediately followed by active exercise, tends to induce a more significant decrease in pain reduction in patients with chronic lower back pain. These results confirm that chiropractic is an appropriate treatment for chronic low-back pain.
While exercise has long been a crucial component of chiropractic care, this study provides further evidence of the efficacy of combining exercise with chiropractic adjustments for relieving chronic pain.
Balthazard P, et al. Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic non specific low back pain: a randomized controlled trial. BMC Musculoskeletal Disorders 2012; 13: 162. doi:10.1186/1471-2474-13-162.
Many headaches arise from cervical musculoskeletal disorders. Often, conservative therapies are recommended as the first treatment for cervicogenic headache, but it was previously unclear which treatments were the most effective. Should patients be prescribed a set of exercises and physical therapy sessions, chiropractic adjustments, or both? Will one lead to better outcomes?
A 2002 study sought to answer these questions by examining the effectiveness of a combination treatment involving both chiropractic adjustments and an exercise program. Two-hundred participants with chronic, moderate intensity cervicogenic headaches were assigned to one of four groups: spinal adjustments, exercise therapy, combined therapy, and a control group. Over six weeks of treatment, they reported their headache frequency, intensity, duration, pain, medication intake, and satisfaction with treatment. Researchers also measured physical outcomes such as pain on neck movement and a photographic measure of posture.
The study showed that all three active treatments (chiropractic adjustments, exercise, and a combination of both) were effective for improving the symptoms of cervicogenic headache, with benefits maintained at least 12 months following treatment. There was no statistical evidence of an additive effect when both chiropractic manipulation and exercise therapy were used simultaneously. Despite patients receiving combined treatments experienced the same clinical benefits as patients in the stand-alone treatment groups, a greater proportion of participants in the combined treatment group experienced good or excellent outcomes. This supports the use of combined treatments for the management of cervicogenic headaches.
Combining chiropractic with exercise can also ease symptoms in patients with neck and back pain.
Jull G, Trott P, Potter H, et al. A randomized controlled trail of exercise and manipulative therapy for cervicogenic headache. Spine 2002; 27(17):1835-1843.
Whiplash injuries are an expensive and painful problem in the US. Experts estimate that we spend $29 billion per year in treating the pain and disability that can result from a rear-end collision.
But there are steps you can take to protect yourself from whiplash injury.The key to good whiplash protection is your head restraint. Numerous studies have shown that most people have an improperly adjusted head restraint, commonly called a head rest.
Whiplash injury occurs when your torso moves in one direction while your head moves in another direction. This can put hundreds of pounds of force on the delicate ligaments of your neck.
The key to good head restraint positioning is to eliminate or reduce the amount of space that your head can move. By doing that, it reduces the strain put on your neck. Your head restraint needs to be placed so that the back of your head is level with the middle of the restraint, and your seat needs to be positioned so that your head is very close. You want to have a maximum of 2.5 inches between your head and the restraint.
While car crashes are often out of your control, you can properly adjust your head restraint toreduce the chance of neck injury during a rear-end collision.
If you've already been injured in a crash, it's important to get treatment right away. Research suggests that chiropractors can provide effective treatments for many patients with whiplash-associated disorders.
Freeman MD, et al. A review and methodologic critique of the literature refuting whiplash syndrome. Spine 1999; 24 (1): 86-96.
Prevent Injury, Adjust your Headrest. CAA South Central Ontario. http://www.caasco.com/insurance/auto-vehicle-insurance/adjust-your-headrest.jsp.
How to Adjust Your Head Restraint. The Royal Society for the Prevention of Accidents. http://www.rospa.com/roadsafety/info/adjust_head_restraints.pdf.
Recent research suggests that a multimodal chiropractic treatment can effectively ease radicular pain.
Radiculopathy, or radicular pain, is a condition related to compression of the spinal nerve roots. This nerve impingement can lead to pain, numbness, tingling, or weakness in parts of the body far from the original source. Radiculopathy is often disabling, and there is little information regarding the most effective course of treatment, though both surgical and non-surgical approaches are common.
A recent review examined the outcomes of conservative, non-surgical treatment of patients with radiculopathy. This review involved 162 patients with a diagnosis of radiculopathy who were treated with chiropractic spinal adjustments, neuromobilization, and exercise stabilization. The frequency and duration of care were determined on an individual patient, though most patients underwent treatment 2 to 3 times per week.
85.5% of the patients experienced resolution of their radicular complaints, after undergoing an average of 9 treatment sessions. Patients experienced an average change in numeric pain scale of 4.2 between the initial and final visit. 23 cases were considered unresolved; those patients were referred for steroid injection, further medication management, or surgery. The researchers concluded that the conservative management strategy explored here produced favorable outcomes for most radiculopathy patients.
This study adds to the knowledge surrounding radiculopathy treatments by demonstrating that a conservative approach utilizing spinal adjustments, in combination with neuromobilization and stabilization exercise, may be effective for the majority of patients with radicular pain.
Christensen KD, Buswell K. Chiropractic outcomes managing radiculopathy in a hospital setting: a retrospective review of 162 patients. Journal of Chiropractic Medicine 2008; 7 (3): 115-25.
Do you ever experience neck stiffness or pain with your headaches? Recent research suggests that neck and head pain are more related than you think.
One study examined whether headaches and cervical spine impairment were linked in patients with head pain. Of the patients evaluated, 90% had cervicogenic headaches, or headaches linked to neck pain. Furthermore, the severity of patients' headaches impacted the range of motion in their necks. This study demonstrates the strong relationship between cervical spine (neck) impairment and cervicogenic headaches.
Visit Dr. Jeremy Hozjan to determine whether your headaches are related to impairment and pain in your neck.
Hall TM, Briffa K, Hopper D, Robinson KW. The relationship between cervicogenic headache and impairment determined by the flexion-rotation test. Journal of Manipulative Physiological Therapy. 2010 Nov-Dec; 33(9):666-71.
Why Chiropractic is the Best Solution for Sciatica Pain
Sciatica and chiropractic
Sciatica pain is often so debilitating that it forces people to miss work and other normal activities. Of all patients with low-back pain, sciatica patients have the highest level of disability (1). In fact, patients with sciatica are disabled for an average of 72 days according to Norwegian public-health records.
Fortunately, a recent study offers hope to sciatica patients: chiropractic care can speed the recovery from sciatica flare ups and allow patients to return to work sooner (2).
The study evaluated 44 Norwegian workers after they came to the hospital with severe sciatica pain. Most of those patients had been experiencing pain for three or more weeks prior to their hospital visit.
The hospital chiropractor examined each patient to evaluate his/her posture and gait, range of motion, and palpation of the lumbar spine.
The chiropractic then performed various joint adjustments to the spine and other limbs that had been injured through patients compensating for pain. Ice treatment was also used to relieve soft tissue soreness.Patients were treated daily in the hospital and later three times a week for the first two weeks. Some patients needed additional follow-up treatment but typically did not exceed 14 treatments.
In matter of 21 days, 91% of patients returned to work full-time. Two patients returned to work part time. Researchers concluded this study demonstrates the potent benefits of collaboration between chiropractors and orthopedic surgeons. Chiropractic care can put an end to your sciatica pain so you can begin living your life fully again.
Arana E, Marti-Bonmati L, Vega M, et al. Relationship between low back pain, disability, MR imaging findings and health care provider. Skeletal Radiology 2006;35(9):641-7.
Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.